War is hell, and one way to deal with it is to drink your troubles away – even if U.S. troops are barred from consuming alcohol in war zones.

But nothing apparently stops many of them once the troops are back home. A new federal study reports that binge-drinking among active-duty troops jumped 34% from 1998 to 2008. Nearly half the troops – 47% — had five or more drinks at a single event in 2008 (four drinks or more for women). Heavy drinkers represented 15% of the U.S. military in 1998; that number in 2008 had risen to 20% (still below 1980’s 21%).

You can also pop pills: prescription drug abuse among active-duty U.S. troops doubled from 2% to 4% between 2002 and 2005, and reached 11% in 2008 – a 450% increase in six years.

Combining booze and pills leads to a startling finding in a study released Monday by the Institute of Medicine, part of the National Academy of Sciences: substance abuse accounted for more time spent in hospitals by U.S. troops last year than any of the other 138 medical conditions and injuries tracked by the Pentagon. The growing abuse is one of the pathologies of the wars in Afghanistan and Iraq, along with increases in post-traumatic stress disorder, depression and suicides.

IOM

Among the 352-page report’s other findings:

— Analyses of record data by the military indicate that alcohol and drug use disorders have been increasing in recent years for the active duty component, the reserve component, and military dependents.— Collectively, the data indicate that excessive alcohol use is a much greater substance use problem than illicit drug use or prescription drug misuse.— Rates of acute and chronic incident alcohol diagnoses increased from 2001 through 2010, especially during the latter part of the decade for the active duty component…The number of bed days attributable to chronic alcohol abuse diagnoses roughly quadrupled over the 10-year period.— Several Army reviews have identified a high proportion of suicides, other deaths, and other negative consequences associated with untreated SUDs [substance use disorders].— Compared with their civilian counterparts, active duty component military personnel were found to be more likely to engage in heavy drinking (a finding driven by personnel aged 18-35); less likely to use illicit drugs (excluding prescription drug misuse) among all age groups; and less likely to use illicit drugs (including prescription drugs) among younger personnel aged 18-25, but more likely to use these drugs among those aged 36 or older (a finding driven by prescription drug misuse).

On the good news front: self-admitted (anonymously) use of illicit drugs by active-duty troops over the past 30 days fell from 28% in 1980 to 3% in 2008.

“Alcohol and other drug use in the armed forces remain unacceptably high, constitute a public health crisis, and both are detrimental to force readiness and psychological fitness,” the report’s summary says. “The highest levels of military leadership must acknowledge these alarming facts and combat them using an arsenal of public health strategies, including proactively attacking substance use problems before they begin by limiting access to certain medications and alcohol.”

IOM

The chairman of the panel that wrote the report lauded steps taken by the Pentagon to deal with substance-abuse challenges, but says more needs to be done.

“Better care for service members and their families is hampered by inadequate prevention strategies, staffing shortages, lack of coverage for services that are proved to work, and stigma associated with these disorders,” said Charles P. O’Brien, psychiatrist and head of the Center for Studies of Addiction at the University of Pennsylvania. IOM creates panels made up of independent scientists and academics to provide policy-makers with expert advice on challenging issues.

The IOM panel lauded the Army’s Confidential Alcohol Treatment and Education pilot program, which it said shows “that active-duty service members use confidential treatment when given the opportunity to do so.” It encouraged the Army to expand its program and that the other services replicate it.

The alternating horrors and humdrummedness of waging war has always made substance abuse a problem: it was rum in the Revolution, and opium addiction became known as the “soldier’s disease” during the Civil War. “The military has a long history of use and abuse of alcohol and other drugs,” the study acknowledges, “and substance use often is exacerbated by deployment and combat exposure.”

This isn't news, it's just an update with a nifty graph tossed in. Look back to WWII. 12 million Americans took part in that war and at least 10% came home as poor shattered bastards who'd never fit into the world again. Another much larger group marginally adapted to life back home -- plenty of beer and Four Roses involved -- because shooting and being shot for a couple years and then going home a week from Friday did nothing to ease the transition. Then drugs got added to the mix and the shiat really hit the fan. "An abnormal reaction to an abnormal situation is normal behavior."

The cost of war doesn't end with funerals and casualties and VA checks, folks.

My husband has been deployed to Afghanistan twice. Both deployments were extremely hard on him. He was with an engineering unit that located and cleared IEDs. The stress and tension was high at all times. Their base was under contact fire and mortar attack from the surrounding mountains. He and many others in his unit began drinking WHILE in Afghanistan. It's the shocking truth that no one wants to talk about. He came home an alcoholic. The worst part about it was that other military wives, friends and family were the ones sending the alcohol to these guys. Sometimes they obtained alcohol from the Bristish soldiers, but mostly it came in care packages from the US. Packed in empty popcorn boxes, laundry detergent, etc...Whatever they could hide it in. By the time my husband and many of these guys came home, they didn't stand a sober chance.

My husband has been deployed to Afghanistan twice. Both deployments were extremely hard on him. He was with an engineering unit that located and cleared IEDs. The stress and tension was high at all times. Their base was under contact fire and mortar attack from the surrounding mountains. He and many others in his unit began drinking WHILE in Afghanistan. It's the shocking truth that no one wants to talk about. He came home an alcoholic. The worst part about it was that other military wives, friends and family were the ones sending the alcohol to these guys. Sometimes they obtained alcohol from the Bristish soldiers, but mostly it came in care packages from the US. Packed in empty popcorn boxes, laundry detergent, etc...Whatever they could hide it in. By the time my husband and many of these guys came home, they didn't stand a sober chance.

The only thing that can 'make' anybody an alcoholic is his or her own decision to continue to drink in spite of strong reasons not to. It's not the fault of people who sent booze to loved ones, or the Army, or his particular assignment. He chose to drink and continues to choose to drink -- quit blaming and get him help.

I did not mean to sound like I was blaming anyone. You are absolutely correct, no one can force anyone to do anything (within reasonable scenarios). He absolutely is responsible for his own actions. This November my husband will have been sober for 2 years—I got him help and he accepted. By sharing my story I was hoping to enlighten people to these situations. My husband is by far not the only one. Many people assume that the abuse begins after a soldier returns home. That is not always the case. Also, many people assume that soldiers do not and can not drink while deployed—that is not entirely true.

Kelly, thanks for the response. I'm sober too and spent a while in early sobriety trying to figured out who or what was responsible for my insane drinking. Then an old timer said "Look kid, did anybody hold you at gunpoint and pour booze down your throat? No? Then you personally chose to drink regardless of the problems, right?" Whew, sure put an end to that foolish debate in a hurry. =)

My congrats to your husband, and to you for being there for him. It work if you work it. Bill

they do it because getting hammered in the privacy of your own home is less career adverse than getting counseling and putting it on your security clearance. Sure, you might keep your clearance, but your leadership won't give you the roles you need to get ahead.

About Binge Drinking in the service, the Royal Navy used to issue 1 full pint of undiluted rum to its sailors daily. At any given moment, up to 1/3 of the crew of a British warship in the 18th and 19th centuries would be hammered. For this and all sorts of other amazing military history-related stories, go and google "thisiswarblog" and check out this amazing site.